Abstract：
BACKGROUND: Aging deteriorates peripheral and central auditory structures and functions. In elders, for an accurate audiological evaluation, it is important to explore beyond the cochlear receptor. Audiograms provide an estimation of hearing thresholds, while the amplitudes and latencies of supra-threshold auditory brainstem response (ABR) can offer noninvasive measures of the auditory pathways functioning. Regarding ABR, in young populations, level-specific chirp (LS CE-chirp) stimulus has been proposed as an alternative synchronizing method to obtain larger ABR responses than those evoked by clicks. However, the supra-threshold characteristics of chirp evoked ABR, and their association to hearing thresholds is relatively unknown in the elderly. The aim of this study was to evaluate supra-threshold LS CE-chirp ABRs in an aged population by comparing their features with click ABRs, and evaluating their relationship with audiometric hearing thresholds.
METHODS: We carried out a cross-sectional study to characterize the hearing of 125 adults aged over 65 years. We determined the audiometric hearing thresholds and supra-threshold ABRs elicited by LS CE-chirp and click stimuli at 80 dB nHL. We evaluated associations by means of partial correlations and covariate adjustment. We performed specific frequencies\' analysis and subgroup analysis per hearing level.
RESULTS: Wave V responses had significantly shorter latencies and larger amplitudes when elicited by LS CE-chirp as compared to click-evoked responses. Audiometric hearing thresholds correlated with age, but ABR characteristics did not. We found mild correlations between hearing thresholds and ABR characteristics, predominantly at higher frequencies and with chirp. We found scarce evidence of correlation between ABR characteristics and the average of behavioral hearing thresholds between 0.5 to 4 kHz (0.5-4 kHz PTA). After subgroup analysis according to the hearing level, no stronger or more significant correlations were found between ABR characteristics and 0.5-4 kHz PTA.
CONCLUSIONS: In this study, we found that supra-threshold LS CE-chirp ABR presented some of the previously described similitudes and differences with supra-threshold click ABR in younger populations. Although, the average amplitude and latency of wave V evoked by LS CE-chirp were larger and faster than those evoked by clicks, these results should be taken with caution at the individual level, and further studies are required to state that LS CE-chirp ABRs are better than click ABRs in elders for clinical evaluations. We did not find consistent associations between hearing thresholds and supra-threshold wave V features, suggesting that these measures should be considered independently in the elderly.
METHODS: We carried out a cross-sectional study to characterize the hearing of 125 adults aged over 65 years. We determined the audiometric hearing thresholds and supra-threshold ABRs elicited by LS CE-chirp and click stimuli at 80 dB nHL. We evaluated associations by means of partial correlations and covariate adjustment. We performed specific frequencies\' analysis and subgroup analysis per hearing level.
RESULTS: Wave V responses had significantly shorter latencies and larger amplitudes when elicited by LS CE-chirp as compared to click-evoked responses. Audiometric hearing thresholds correlated with age, but ABR characteristics did not. We found mild correlations between hearing thresholds and ABR characteristics, predominantly at higher frequencies and with chirp. We found scarce evidence of correlation between ABR characteristics and the average of behavioral hearing thresholds between 0.5 to 4 kHz (0.5-4 kHz PTA). After subgroup analysis according to the hearing level, no stronger or more significant correlations were found between ABR characteristics and 0.5-4 kHz PTA.
CONCLUSIONS: In this study, we found that supra-threshold LS CE-chirp ABR presented some of the previously described similitudes and differences with supra-threshold click ABR in younger populations. Although, the average amplitude and latency of wave V evoked by LS CE-chirp were larger and faster than those evoked by clicks, these results should be taken with caution at the individual level, and further studies are required to state that LS CE-chirp ABRs are better than click ABRs in elders for clinical evaluations. We did not find consistent associations between hearing thresholds and supra-threshold wave V features, suggesting that these measures should be considered independently in the elderly.
摘要：
背景：衰老会使周围和中枢听觉结构和功能恶化。在长辈中，为了准确的听力学评估，重要的是探索超越耳蜗受体。听力图提供了对听阈的估计,而阈上听性脑干反应(ABR)的幅度和潜伏期可以提供听觉通路功能的非侵入性测量。关于ABR,在年轻人群中，已提出水平特定的chi（LSCE-chi）刺激作为一种替代同步方法，以获得比点击引起的ABR响应更大的ABR响应。然而,啁啾诱发ABR的超阈值特征，在老年人中，它们与听力阈值的关联相对未知。这项研究的目的是通过比较老年人群的特征与点击ABR来评估超阈值LSCE-chirpABR，并评估它们与听力测量听力阈值的关系。
方法：我们进行了一项横断面研究，以表征125名65岁以上成年人的听力。我们确定了在80dBnHL下由LSCEchi和点击刺激引起的听力测定听力阈值和超阈值ABR。我们通过部分相关和协变量调整来评估关联。我们根据听力水平进行了特定频率分析和亚组分析。
结果：与点击诱发反应相比，LSCE-chirp引起的V波反应具有明显更短的潜伏期和更大的振幅。听力测定听力阈值与年龄相关，但ABR特征没有。我们发现听力阈值和ABR特征之间存在轻度相关性，主要在较高的频率和啁啾。我们发现很少有证据表明ABR特征与0.5至4kHz（0.5-4kHzPTA）之间的平均行为听力阈值之间存在相关性。根据听力水平进行亚组分析后，在ABR特征和0.5-4kHzPTA之间没有发现更强或更显著的相关性.
结论：在这项研究中，我们发现,在年轻人群中,超阈值LSCE-chirpABR与超阈值点击ABR呈现了一些先前描述的相似性和差异.虽然,LSCE-chirp诱发的V波的平均振幅和潜伏期比咔嗒诱发的平均振幅和潜伏期更大，更快，这些结果应该在个人层面上谨慎对待，需要进一步的研究表明，在临床评估中，LSCE-chirpABR优于老年人的点击ABR。我们没有发现听力阈值和超阈值波V特征之间的一致关联，建议这些措施应该在老年人中独立考虑。
方法：我们进行了一项横断面研究，以表征125名65岁以上成年人的听力。我们确定了在80dBnHL下由LSCEchi和点击刺激引起的听力测定听力阈值和超阈值ABR。我们通过部分相关和协变量调整来评估关联。我们根据听力水平进行了特定频率分析和亚组分析。
结果：与点击诱发反应相比，LSCE-chirp引起的V波反应具有明显更短的潜伏期和更大的振幅。听力测定听力阈值与年龄相关，但ABR特征没有。我们发现听力阈值和ABR特征之间存在轻度相关性，主要在较高的频率和啁啾。我们发现很少有证据表明ABR特征与0.5至4kHz（0.5-4kHzPTA）之间的平均行为听力阈值之间存在相关性。根据听力水平进行亚组分析后，在ABR特征和0.5-4kHzPTA之间没有发现更强或更显著的相关性.
结论：在这项研究中，我们发现,在年轻人群中,超阈值LSCE-chirpABR与超阈值点击ABR呈现了一些先前描述的相似性和差异.虽然,LSCE-chirp诱发的V波的平均振幅和潜伏期比咔嗒诱发的平均振幅和潜伏期更大，更快，这些结果应该在个人层面上谨慎对待，需要进一步的研究表明，在临床评估中，LSCE-chirpABR优于老年人的点击ABR。我们没有发现听力阈值和超阈值波V特征之间的一致关联，建议这些措施应该在老年人中独立考虑。
